Provider Demographics
NPI:1891852679
Name:MAY, GEORGE W JR (DMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:MAY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 E. LAYFAIR DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9527
Mailing Address - Country:US
Mailing Address - Phone:601-932-3607
Mailing Address - Fax:601-932-3610
Practice Address - Street 1:293 E. LAYFAIR DRIVE
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9527
Practice Address - Country:US
Practice Address - Phone:601-932-3607
Practice Address - Fax:601-932-3610
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2284-861223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSU04501Medicare UPIN